NPI | 1295254589 |
---|---|
Entity Type | Organization |
Authorized Contact | ALAN J ACIERNO Manager 630-339-3172 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019031185) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019029852) |
1223G0001X Dentist, General Practice (Licence: IL 019025570) | |
1223G0001X Dentist, General Practice (Licence: IL 019026827) | |
Enumeration Date | 2017-09-18 |
Last Update Date | 2017-09-18 |